Presented to Parliament, the report shows that 16 Regional Referral Hospitals and five National Referral Hospitals are operating critical care units with severe shortages of specialised medical personnel, with some senior nursing cadres recording a 100% vacancy rate.
The Auditor General warns that these “acute staffing shortages” are undermining the country’s ability to deliver life-saving services and are forcing patients to seek costly treatment in private facilities.
“These staffing gaps undermine the country’s ability to provide high-quality critical care services,” the report states, noting that the absence of specialists is increasing both patient mortality and the financial burden on families.
The audit paints a grim picture of intensive care units that exist largely in infrastructure and equipment, but lack the specialised human resources required to manage critically ill patients.
Of the 20 approved positions for Senior Consultant Intensivists nationwide, only one is currently filled, translating into a 95% vacancy rate.
The situation is even more severe among senior nursing leadership, where all positions for Principal Nursing Officers in critical care remain vacant.
“It is apparent that the project portfolio’s performance is below average,” the report notes, linking chronic understaffing to the underutilisation and rapid depreciation of expensive medical equipment.
The audit found a 98% vacancy rate among Medical Officer Special Grades and a 91% shortfall in specialised Nursing Officers, raising concerns that the intended life-saving role of these units is being fundamentally compromised.
The staffing crisis extends well beyond intensive care. Public health facilities, the Auditor General observed, are “grappling with the challenge of lack of health care specialists” across multiple disciplines.
Emergency Medicine services are 64% understaffed, while Pathology and Psychiatry both face vacancy rates of 66%.
The report attributes the crisis to high entry requirements, inadequate wage allocations and significant pay disparities between public service and private practice.
Preventive healthcare systems are also under strain. The audit warns of a growing risk to vaccine safety due to an aging cold chain infrastructure, with nearly half of all equipment having been in use for more than seven years.
In addition, the Auditor General found that 10 districts received more than 1.7 million vaccine doses without comprehensive needs assessments, creating a high risk of overstocking and vaccine wastage through expiries.
In his recommendations, the Auditor General advised the Ministry of Health to work closely with the Ministry of Public Service and the Health Service Commission to develop and implement a comprehensive strategy to urgently address the critical staffing gaps.
He also called for the prioritisation of routine maintenance and timely replacement of aging equipment to avert a potential disruption of the national immunisation programme.